Comparison of the Logical Use of Parenteral Antibiotics Before and After the Implementation of the Stewardship Program

Abstract

Background: Excessive use of antibiotics has led to drug resistance. As such, stewardship programs are implemented to control antibiotic use in hospitalized patients. Objectives: The present study aimed to evaluate the frequency of antibiotic use after the implementation of the stewardship program. Methods: This retrospective study was conducted on the patients admitted to Imam Reza Hospital in Kermanshah, Iran during 2017 - 2018. The required data were extracted from the pharmaceutical ward of the hospital. Data analysis was performed in SPSS version 24. Results: The median per capita numerical and Rial consumption of caspofungin and linezolid antibiotics increased after the implementation of the stewardship plan, while the consumption of imipenem, amphotericin, teicoplanin, colistin, meropenem, voriconazole, and vancomycin was observed to decrease. In addition, the median per capita of the numerical use of caspofungin and linezolid increased in the surgery ward, intensive care unit (ICU), and internal medicine ward after the implementation of the stewardship plan. On the other hand, a reduction was observed in the use of amphotericin, colistin, voriconazole, and vancomycin in only one ward. The use of meropenem and teicoplanin also increased in the surgery ward and decreased in the other wards, while the use of imipenem increased in the ICU after implementing the plan and decreased in the other wards. The median use of antibiotics was not considered significant in the internal medicine ward, surgery ward, and ICU before and after implementing the stewardship program (P > 0.05). Conclusions: According to the results, antibiotic use slightly decreased after the implementation of the stewardship program. However, an increase was also observed in antibiotic prescription in some cases, which indicated that the stewardship program was not implemented properly, and no changes occurred in antibiotics prescription.